She has worked in television and theatre as both actress and writer. Her first credited television appearance, though inauspicious, was as a terrified diner in The Bill in 1984, running frantically out of a Chinese restaurant after it had received a bomb scare. A year later she appeared as an alien in the Doctor Who serial Attack of the Cybermen.[2] Her novels include the semi-autobiographical Hideous Kinky, which was adapted into a film starring Kate Winslet.

Freud was named as one of the 20 "Best of Young British Novelists" by Granta magazine in 1993.[4] Her novels have been translated into 13 languages.[5] She is also the co-founder (with Kitty Aldridge) of the women's theatre company Norfolk Broads.

In 2009, she donated the short story Rice Cakes and Starbucks to Oxfam's 'Ox-Tales' project, four collections of UK stories written by 38 authors. Her story was published in the 'Water' collection.[6]